BACKGROUND: Cancer has profound effects on gene expression, including a cell's glycosylation machinery. Thus, tumors produce glycoproteins that carry oligosaccharides with structures that are markedly different from the same protein produced by a normal cell. A single protein can have many glycosylation sites that greatly amplify the signals they generate compared with their protein backbones. CONTENT: In this article, we survey clinical tests that target carbohydrate modifications for diagnosing and treating cancer. We present the biological relevance of glycosylation to disease progression by highlighting the role these structures play in adhesion, signaling, and metastasis and then address current methodological approaches to biomarker discovery that capitalize on selectively capturing tumor-associated glycoforms to enrich and identify disease-related candidate analytes. Finally, we discuss emerging technologies-multiple reaction monitoring and lectin-antibody arrays-as potential tools for biomarker validation studies in pursuit of clinically useful tests. SUMMARY: The future of carbohydrate-based biomarker studies has arrived. At all stages, from discovery through verification and deployment into clinics, glycosylation should be considered a primary readout or a way of increasing the sensitivity and specificity of protein-based analyses.

Trypanosoma cruzi at various stages of maturation and differentiation have been isolated by conventional cellular fractionation procedures and characterized by cell surface markers using 30 highly purified lectins encompassing all known sugar specificities. Cell surface carbohydrates of the various T. cruzi stages were analyzed by agglutination and lectin-binding assays. Specific receptors for wheat germ agglutinin (WGA), Helix pomatia, Sophora japonica, and Bandeiraea simplicifolia lectin II were found only in culture epimastigotes, whereas peanut agglutinin (PNA) sites were present exclusively in amastigotes, those for Phaseolus vulgaris in bloodstream trypomastigotes and amastigotes, and for Wistaria floribunda hemagglutinin predominantly in culture forms of T. cruzi. The N-acetylgalactosamine (DGalNAc)-binding lectin from Bauhinia purpurea agglutinated and inhibited the movement of epimastigotes and bloodstream trypomastigotes, but it only inhibited--without agglutinating--culture trypomastigotes. Because both the agglutination and inhibition of movement were reversed by specific sugar haptens, Bauhinia purpurea sites were present in all the flagellated parasites. On the other hand, PNA sites were detectable on epimastigotes after the cells were treated with sialidase, whereas, at the same time, WGA receptors were completely removed and those for the other sialic acid-binding proteins, Aaptos papillata lectin II and Limulus polyphemus, were partially eliminated; moreover, the activity of Wistaria floribunda hemagglutinin, a DGalNAc-binding lectin, increased 4,000 times. Trypsinization and lyzozyme treatment of epimastigote cells did not significantly affect lectin agglutination or lectin binding. WGA reacted solely with sialic acid residues on epimastigote cell surface with an apparent association constant of 2 x 10(6) M-1, each epimastigote having an estimated average of 3 x 10(6) WGA sites, as determined by binding experiments and a minimum of 7.7 x 10(6) sialic acid residues, as calculated by colorimetric method after sialidase digestion. Evidences are presented that the sialyl residues are rapidly regenerated (in approximately 4 h) and that they, at least for the most part, are not adsorbed from the culture medium. The receptor for the D-mannose-binding lectins (concanavalin A [Con A] and Lens culinaris) must either be on the same carbohydrate moiety having the WGA site, or, if in a distinct molecule, both carrier molecules of Con A and WGA sites must be located close to each other in the plasma membrane of the parasite.

Epithelial cells may relate to their basement membrane substrates via lectin-like interactions. In a model system for study of this type of interaction, lectin-coated bacteriological plastic petri dishes were presented as substrates for epithelial cell adhesion. Of 21 lectins tested by mixed agglutination against two epithelial cell types, Madin-Darby canine kidney (MDCK), and human embryonic kidney cells (HEK), nine gave less than 5% rosettes and 12 gave 5 to 50% rosettes. Wheat germ agglutinin (WGA) and Geodia cydonium lectin gave the highest percentage of rosettes. Wheat germ agglutinin was readily adsorbed to plastic surfaces and maintained specificity in binding interactions. Both MDCK and HEK cells attached as well to WGA coated petri dishes as to conventional tissue culture dishes. Furthermore, both spread over the lectin-coated surfaces. The MDCK cells grew to confluence and could be subcultured and maintained indefinitely on such surfaces, although WGA in solution was toxic to the cells in concentrations as low as 0.1 to 1.0 microgram/ml. Cell attachment to WGA coated dishes was blocked by cycloheximide only if the cells had been preincubated with the inhibitor for several hours. Cell attachment was not inhibited by pretreatment of cells with neuraminidase. Precoating cells with WGA blocked binding to both WGA-coated surfaces and untreated tissue culture dishes. Cells attached to WGA-coated dishes could not be readily dislodged by trypsin-EDTA for the first 2 h after subculture. By 4 h, attachment was again trypsin sensitive, suggesting that the cells synthesized a trypsin-sensitive material that was laid down between the cell surface and the WGA-coated dish. Regeneration of trypsin sensitivity was not blocked by cycloheximide.

Salmonella telaviv, Salmonella tranoroa, and Salmonella illinois were examined for their ability to interact with 15 purified lectins of known sugar specificity. The only interaction observed was between the lectin of Maclura pomifera and S. telaviv. M. pomifera lectin specifically agglutinated suspensions of S. telaviv and precipitated with its purified lipopolysaccharide and isolated lipid A free O polysaccharide. Quantitative inhibition assays showing methyl-alpha-D-galactopyranoside and N-acetyl-D-galactosamine to be potent inhibitors of Maclura lectin precipitation by S. telaviv O polysaccharide suggest that the interaction is mediated by D-galactose or N-acetyl-D-galactosamine units of bacterial polysaccharide structure, or both.

Lectins react with a wide range of different carbohydrates (Table 1). Even so-called monospecific anti-H(O) lectins from Lotus tetragonolobus, Ulex europaeus, and Anguilla anguilla react not only with the anti-H determinant but also with several fucosylated carbohydrates. Consequently, the type of lectin receptor existing on the surface of Pneumocystis carinii should be determined, because only a carbohydrate analysis can demonstrate the kind of carbohydrates which exist on the cell surface of this parasite. For the purpose of this study we used fluorescent isothiocyanata (FITC)-conjugated lectins. Concanavalin A (Con A) and Maclura pomifera (MPA) agglutinin reacted to P. carinii at low concentrations, and the fluorescence intensity was gradually increased with the concentration of the lectins. With lectins from Bauhinia purpurea (BPA), Dolichos biflorus (DBA), Glycine max (SBA), Griffonia simplicifolia (GS-I, GS-II), and Triticum vulgaris (WGA), fluorescence was emitted at high concentrations, while Arachis hypogaea (PNA) and Ulex europaeus (UEA-I) agglutinins did not show fluorescence. The results suggest that P. carinii has abundant Con A- and MPA-specific carbohydrates on the surface.

An isolectin (BS I-B4) derived from Bandeiraea simplicifolia seeds and specific for terminal alpha-D-galactopyranosyl groups was found to be cytotoxic to Swiss 3T3 mouse cells. After mutagenesis and selection with BS I-B4, a variant clonal cell line resistant to both this isolectin and the alpha-D- and beta-D-galactose-binding lectin abrin was isolated. The parental cell line showed homogeneous and noninteracting binding sites for BS I-B4, whereas the variant cells exhibited a curved plot with a reduced number of binding regions. Another lectin, BS II, which is derived from the same seeds by specific for terminal N-acetyl-D-glucosaminyl groups, was cytotoxic to the variant but not the parental cells. These results suggest a possible lesion in the biosynthesis of cell surface structures resulting in the exposure of subterminal N-acetyl-D-glucosaminyl moieties in the variant line.

Isomaltose oligosaccharides varying in size from two sugars, isomaltose (IM2), to seven sugars, isomaltohepatose (IM7), were coupled to stearylamine by reductive amination with sodium cyanoborohydride. Each compound was purified by column chromatography to yield a series of glycolipids containing oligosaccharides differing in length. Stearyl-isomaltotriose to stearyl-IM7 could be incorporated into liposomes and could render them agglutinable by specific antibodies to alpha 1 leads to 6 dextran and could be lysed if complement was also added, whereas those containing stearyl-IM2 were not agglutinated or lysed, indicating that stearyl-IM2 may not be protruding from the liposome surface sufficiently to react with the antibody. Stearyl-isomaltosyl oligosaccharides by themselves or incorporated into liposomes were equally antigenic when emulsified in complete Freund's adjuvant. They elicited pauciclonal responses, and the antibodies were alpha 1 leads to 6 specific, cross-reacted with dextran, and gave semirestricted isoelectric focusing patterns.

Association constants for the binding of methyl alpha-D-galactopyranoside (methyl alpha-D-Galp) and methyl 2-acetamido-2-deoxy-alpha-D-galactopyranoside (methyl alpha-D-GalNAcp) to three Bandeiraea simplicifolia isolectins (A4, A2B2, B4) were determined by equilibrium dialysis and fluorescence enhancement measurements. The a and B subunits appear to have approximately the same Kassoc for methyl alpha-D-Galp: 1.45 X 10(4), 1.98 X 10(4), and 2.06 X 10(4) M-1 for A4, A2B2, and B4, respectively, as determined by equilibrium dialysis. Fluorescence enhancement measurements on B4 gave an association constant of 2.07 X 10(4) M-1 for methyl alpha-D-Galp and 1.87 X 10(3) M-1 for methyl beta-D-galp. By equilibrium dialysis, we were able to detect 3.3 (theory, 4.0) methyl alpha-D-GalNAcp binding sites for A4 (Kassoc = 1.87 X 10(5) M-1), 1.9 for A2B2 (Kassoc = 1.19 X 10(5) M-1), and were unable to detect any methyl alpha-D-GalNAcp binding sites for B4. However, four very weak methyl alpha-D-GalNAc binding sites for B4 were detected by fluorescence enhancement measurement (Kassoc = 1.26 X 10(2) M-1). Thus, the A subunit has an affinity for methyl alpha-D-GalNAc 3 orders of magnitude greater than the B subunit. Precipitation and hapten inhibition data are in accord with these binding measurements. Toward guaran and type B blood group substance, all isolectins precipitated the same amount of biopolymer. However, AB3, A2B2, and A3B, which are mono-, di-, and trivalent for alpha-D-GalNAcp, were differentially precipitated by type A blood group substance which contains alpha-D-GalNAcp-end groups. A3B precipitated the most, A2B2 less, and AB3 no type A substance. These isolectins should prove useful in studies evaluating the effect of valence on lectin-cell interaction.

The combining site of the lima bean (Phaseolus lunatus) lectin (LBL) was studied by quantitative precipitin and precipitin-inhibition assays. The lectin precipitated best with hog gastric mucosa and human ovarian cyst blood group A1 substances and moderately with A2 substances. B substances precipitated very poorly and H, Lea, Leb, and precursor I substances did not react. Blood group A1 and A2 substances reacted to varying extents and these differences are attributable to heterogeneity resulting from incomplete biosynthesis of carbohydrate chains. By inhibition of precipitation of LBL with A1 blood group substance, the lectin was found to be most specific for fucose-containing oligosaccharides having the A trisaccharide, DGalNAc alpha 1----3[L-Fuc alpha 1----2]DGal determinant. The best inhibitor, an A-specific hexasaccharide, DGalNAc alpha 1----3[LFuc alpha 1----2]DGal beta 1----3DGlcNAc beta 1----3-DGal beta 1----4DGlc, was 11 times more active than the A trisaccharide. A difucosyl oligosaccharide with a second fucose linked alpha 1----3 to the DGlcNAc is less active; fucose linked alpha 1----4 to DGlcNAc was completely inactive. These results suggest that specific interactions with the subterminal sugars may be important in the binding, and that the specificity of the lectin combining site involves at least the nonreducing terminal four and probably five sugars of the hexasaccharide. Thus LBL has a more-extended binding site than was inferred previously and is in the upper range of antibody combining-site sizes.